Abstract:

Objective To investigate the current situation of implant use and management in 1225 hospitals in China,and to analyze the existing problems,so as to provide references for the standard management of perioperative implants,and lay a research foundation for the formulation of relevant standards. Methods In May 2021,stratified sampling method was adopted to select operating room management personnel from 1225 hospitals in China. The persons in charge were set in the provinces,autonomous regions and municipalities directly under the central government. All the persons in charge were members of the surgical equipment and materials professional group of Nursing Equipment and Materials Branch of China Medical Equipment Association. Questionnaires were made through the Questionnaire Star and distributed and collected through the WeChat group. A self-designed questionnaire was used,including general information and “Questionnaire on Current Situation of Use and Management of Perioperative Implants”. Results In terms of implant management mode,there were mainly 3 modes,namely three-level management of the equipment department,operating room and specialist group（72.73%）,on-board management of the equipment department（12.24%）,and self-management of the clinical use department（10.69%）. There were great differences among different types of hospitals. In terms of receiving foreign devices and implants,there are still some problems,such as late delivery of suppliers and non-standard charges. In terms of implant traceability management,68.90% introduced an information system to trace the use of implants;62.29% carried out information traceability of the cleaning,disinfection and sterilization process of foreign instruments and implants;48.89% carried out scanning charge and traceability management of implants,indicating that information construction needs to be strengthened. In addition,there are many problems and safety risks in the treatment of unused implants after removal or unpacking and related training,which need to be improved. Conclusion Relevant departments and managers should improve the relevant system and process management according to the scale and actual conditions of different hospitals,strengthen the supervision of implant access,and the whole process information tracing management. Relevant standards should be established in time for non-use of implants after removal and unpacking,so as to fill the management gaps. Supervision over the implementation of existing standards should be strengthened.

Key words: Perioperative Period, Operating Room, Implants, Management, Status Survey, Nursing Care

摘要：

目的 调查全国1 225所医院在围手术期植入物使用与管理的现状,剖析存在问题,为围手术期植入物规范管理提出参考意见,同时为相关标准制订奠定研究基础。方法 2021年5月采用分层抽样法选取全国1 225所医院手术室管理人员,在各省、自治区、直辖市设置负责人,负责人均为中国医学装备协会护理装备与材料分会手术装备与材料专业学组委员。将自行设计的调查问卷,通过问卷星制作成电子问卷并通过微信群进行问卷发放与回收。结果 在植入物管理模式方面主要存在3种方式：设备科（资产管理处）-手术室-专科组三级管理（72.73%）,设备科（资产管理处）入驻式管理（12.24%）,临床使用科室自行管理（10.69%）,不同规模及类型医院存在较大差异;在外来器械与植入物接收方面仍存在供货商晚于规定时间送达、收费不规范等问题;在植入物追溯管理方面,68.90%的医院引入信息系统对植入物的使用进行追溯,62.29%的医院对外来器械及植入物的清洗、消毒及灭菌过程进行信息化追溯,48.89%的医院对植入物进行扫描收费及追溯管理,信息化建设有待加强。另外,在植入物取出或拆封后未使用的处理以及相关培训开展方面均有诸多问题及安全隐患,有待改善。 结论 相关部门及管理者应根据不同医院规模及实际情况完善相关制度及流程管理,加强对植入物准入的监督、全流程信息化追溯管理;在植入物取出和拆封后未使用方面应及时建立相关标准,填补管理盲区;对已有标准的落实情况应加强监督。

关键词: 围手术期, 手术室, 植入物, 管理, 现状调查, 护理